Stacy Shanette Saljoughi, BA IN KINESIOLOGY

Primary specialty

Attendant Care ProviderTaxonomy code 3747A0650X

Practice address

921 Crawford St Apt 4106
Fort Worth, TX 76104-3481

Phone

(817) 891-2471

NPI assigned

May 19, 2023

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other names 1

• Miss Stacy Shanette Gholston Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Arts

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1684454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750291200000",
    "number": "1558052597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 FLYAWAY LN",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761201634",
            "telephone_number": "817-891-2471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "921 CRAWFORD ST APT 4106",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761043481",
            "telephone_number": "817-891-2471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALJOUGHI",
        "first_name": "STACY",
        "middle_name": "SHANETTE",
        "name_prefix": "Mrs.",
        "credential": "BA IN KINESIOLOGY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-19",
        "last_updated": "2025-06-19",
        "certification_date": "2025-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747A0650X",
            "taxonomy_group": "",
            "desc": "Technician, Attendant Care Provider",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "347C00000X",
            "taxonomy_group": "",
            "desc": "Private Vehicle",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACY",
            "last_name": "GHOLSTON",
            "middle_name": "SHANETTE",
            "prefix": "MISS",
            "credential": "BA IN KINESIOLOGY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• David Salib, DPT
• David Salib, DPT
• Salil Mehta DMD PC
• Alyssa Noelle Salinas, LMT
• Erica Salinas, LPC
• Donna Jean Sallee, FNP
• Erika Sallee, PT
• Shannon Salley
• Sally a Hallgren, D.O., P.a.
• Sally'S Care Inc.

• Attendant Care Provider in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Attendant Care Provider in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.